Kornimate/medical-research-clean huggingface dataset:
opioid compromise in hypertension--modulating factors

Conditions: Cardiovascular Diseases; Heart Diseases; Hypertension

Summary: to confirm the preliminary findings of age, race, and hypertension chronicity effects on opioid and cardiovascular responses to stress and to determine the opioid mechanisms mediating these effects using an opioid receptor blockade strategy.

background: opioids exert depressor effects on cardiovascular responses through sympathetic nervous system inhibition. research suggests that opioid inhibition of sympathetic activity may be compromised in hypertension. preliminary studies by the principal investigator suggest that the nature of this compromise may be influenced by age and race. additionally, literature suggests that hypertension chronicity may modulate opioid sympathoinhibitory actions. the receptor mechanisms mediating the observed modulating effects of age, race, and hypertension chronicity on opioidergic inhibition and regulation of blood pressure remained to be determined. design narrative: two double-blind, placebo-controlled cross-over studies were conducted to evaluate the effects of naltrexone hydrochloride, an oral opiate antagonist, on adrenergically-mediated cardiovascular responses in older and younger, black and white normotensives and hypertensives with varying lengths of hypertension duration. cardiovascular and opioid responses were measured in response to a stressor combined with either placebo or naltrexone pretreatment. results from these studies assisted in (a) elucidating opioidergic mechanisms underlying the increased rates of hypertension morbidity and mortality among blacks and the elderly, and (b) ultimately optimized the design of pharmacological interventions for the prevention and treatment of hypertension. the study completion date listed in this record was obtained from the "end date" entered in the protocol registration and results system (prs) record.

Eligibility criteria:
no eligibility criteria
retrospective analysis of capsaïcin patch in complex regional pain syndrome

Conditions: Complex Regional Pain Syndromes

Summary: complex regional pain syndrome is a painful syndrome often secondary to a traumatic lesion. treatment is difficult, of long duration with variable outcomes. patch of capsaïcin has been proposed as adjuvant to a multimodal treatment. capsaïcin may act by its effect on transient receptor potential vanilloid 1. efficacity and outcome studies with this treatment are lacking. the aim of this retrospective study is to evaluate pain intensity over time assessed by visual analog scale in patient with complex regional pain syndrome treated with capsaïcin patch in addition to their usual treatment.


Eligibility criteria:
inclusion criteria: * adult patients with complex regional pain syndrome on maximum medical treatment * age ≥18 years * patients treated between 2012 and august 31, 2022 in the pain clinic of the chu brugmann exclusion criteria: - incomplete medical chart
effects of levosimendan on diaphragm function in mechanically ventilated patients

Conditions: Muscle Weakness Conditions; Weaning Failure

Summary: levosimendan is a relatively new drug that improves cardiac contractility in patients with heart failure. its main mechanism of action is enhanced binding of calcium to the myocardial contractile proteins. recent data from our lab showed that levosimendan improves contractility of human diaphragm in vitro (muscle fibers from copd patient diaphragm) and in vivo (healthy subjects). accordingly, levosimendan may appear of value in the treatment of disorders associated with impaired respiratory muscle function, such as mechanically ventilated patients.we hypothesize that levosimendan could improve respiratory muscle function in mechanically ventilated patients commencing a cpap trial.


Eligibility criteria:
inclusion criteria: * mechanical ventilation \> 3 days * informed consent * able to sustain a cpap trial for 30 minutes * pao2/fio2 ratio \> 200 mmhg * ventilatory settings: positive end expiratory pressure \<= 10 cmh2o, pressure support \<= 10 cmh2o exclusion criteria: * pre-existent muscle disease (congenital or acquired) or diseases/disorders known to be associated with myopathy including auto-immune diseases * pre-existent cardiac disease (based on history, electrocardiography and transthoracic echocardiography) * upper airway/esophageal pathology (i.e. recent surgery, esophageal varices, diaphragmatic hernia) * phrenic nerve lesions * pregnancy, breast feeding * severe renal failure (serum creatinine \> 150 umol/l) * severe hepatic failure * recent (within 5 days) nasal bleeding * systolic blood pressure \< 120 mmhg

Keywords: levosimendan diaphragm function mechanically ventilated patients neuro-mechanical efficiency
peptide receptor radionuclide therapy (prrt) for the treatment of neuroendocrine tumors

Conditions: Neuroendocrine Tumors

Summary: the specific aim is of this study is to gain a better understanding of the patient characteristics, treatment responses, survival outcomes, and adverse events associated with prrt in patients with gastroenteropancreatic primary nets.

neuroendocrine tumors (nets) make up a large range of malignancies that arise from neuroendocrine cells in multiple organs of the body. hallet et al conducted a large population-based study that demonstrated that 21% of net patients presented with metastatic disease and another 38% developed metastases after resection of the primary tumor (hallet et al., 2015). this burden demonstrates the need for effective systemic therapy for advanced nets. options for systemic therapy include peptide receptor radionuclide therapy (prrt). a need for more prospective series are needed on treatment responses and survival outcomes related to gastroenteropancreatic primary nets treated with prrt was identified. thus the purpose of this study is to collect clinical data related to treatment of gastroenteropancreatic primary nets s with prrt. clinical data related to patient characteristics, treatment responses and survival outcomes related to the treatment of gastroenteropancreatic primary nets with prrt and on adverse events and complications related to prrt treatment will be collected.

Eligibility criteria:
inclusion criteria: 1. \> 18 years of age 2. diagnosed with gastroenteropancreatic primary net and has consented to undergo prrt per the treating physician. specifically: * will consider other primaries on a case by case basis if dotatate scan (+) and meet all other criteria. * metastatic or locally advanced and inoperable * clear disease progression on octreotide over less than 3 years (recist 1.1) * presence of disease within 24 weeks as identified by pet/ct scans with ga-68 dotatate reporting the krenning score for low-grade net and/or pet/ct scans with fdg for transformation to high-grade net * well differentiated on path - ki67 \< 20% * octreotide positive on pathology (if not documented, acceptable if pet/ct imaging shows lesions with ga-68 dotatate uptakelabs: * cr. \<1.7 * hgb \>8 * wbc \>2k * plt \>75k * bili \< 3x normal limit * no octreotide within 30 days of administration. 3. willing and able to comply with the protocol requirements 4. able to comprehend and sign the informed consent form in english. exclusion criteria: * do not meet the study inclusion criteria laid out in section 6.3
vaccine therapy in treating patients with liver cancer

Conditions: Liver Cancer

Summary: rationale: vaccines made from a person's white blood cells mixed with tumor proteins may make the body build an immune response to kill tumor cells. purpose: phase i/ii trial to study the effectiveness of vaccine therapy in treating patients who have liver cancer.

objectives: * determine the maximum tolerated dose of alpha-fetoprotein peptide-pulsed autologous dendritic cells in hla-a\*0201-positive patients with hepatocellular carcinoma. * determine the safety and toxicity of this regimen in these patients. * determine the immunological effects of this regimen in these patients. * determine the progression-free survival and clinical responses in patients treated with this regimen. outline: this is a dose-escalation study. patients receive alpha-fetoprotein peptide-pulsed autologous dendritic cells intradermally on day 1. treatment repeats every 2 weeks for a total of 3 doses in the absence of unacceptable toxicity. cohorts of 3-12 patients receive escalating doses of vaccine until the maximum tolerated dose (mtd) is determined. the mtd is defined as the dose preceding that at which 2 of 6 or 2 of 12 patients experience dose-limiting toxicity. patients are followed at weeks 1, 4, and 12 and then every 6 months thereafter. projected accrual: a total of 12-18 patients will be accrued for this study.

Eligibility criteria:
inclusion criteria: * hla-a\*0201 positive adults over the age of 18. * have hcc with a serum afp determination \>30ng/ml. * both male and female patients may be enrolled. * karnofsky performance status greater than or equal to 70 percent. * no previous evidence of class 3 or greater new york heart association cardiac insufficiency or coronary artery disease. * no previous evidence of opportunistic infection. * adequate baseline hematological function as assessed by the following laboratory values with 30 days prior to study entry: 1. hemoglobin \>9.0g/dl 2. platelets \>50000/mm3 3. absolute neutrophil count \>1,000/mm3 * child-pugh class a or b for chronic liver disease. * ability to give informed consent. exclusion criteria: * any congenital or acquired condition leading to inability to generate an immune response, including concomitant immune suppressive therapy. * concomitant steroid therapy or chemotherapy, or any of these other treatments \< 30 days before the first vaccination. * females of child-bearing potential must have negative serum beta-hcg pregnancy test (within day -14 to day 0). * acute infection: any acute viral, bacterial, or fungal infection, which requires specific therapy. acute therapy must have been completed within 14 days prior to study treatment. * hiv-infected patients. * patients with any underlying conditions which would contraindicate therapy with study treatment. * patients with organ allografts. * o2 sat \<91% on room air; dyspnea at rest.

Keywords: localized resectable adult primary liver cancer localized unresectable adult primary liver cancer advanced adult primary liver cancer recurrent adult primary liver cancer adult primary hepatocellular carcinoma
geographic modeling of traffic and asthma rates

Conditions: Asthma

Summary: this study surveys the parents/guardians about symptoms and diagnosis of asthma in kindergarten and first-grade students in 13 schools around the city of anchorage, alaska. traffic information is also measured and entered in geographical information mapping system with student's home and school locations. the study will assess whether students living in high traffic areas have greater risk of diagnosis of asthma.

survey was distributed through the schools. parents/guardians were asked about indoor exposures such as environmental tobacco smoke, insects, mold, woodstoves, as well as demographic information about the child and housing type, income,also biologic information about parental asthma. questions included symptoms of respiratory illness as well as wheezing and medication use. civil engineering department measured traffic on local roadways and gathered traffic information from state and municipal sources regarding traffic on arterioles and major traffic arteries. all information was entered into geographical information system (gis) including the closest cross-streets to the child's home and the school location. traffic exposure variables are being developed for each child and will be added to the database on indoor exposures. a regression model will be used to determine the significance of traffic exposure in receiving a diagnosis of asthma for children five to seven years of age.

Eligibility criteria:

Keywords: childhood asthma traffic
the pharmacokinetics and pharmacodynamics study of single and multiple dose of sp2086 in type 2 diabetes patients

Conditions: Type 2 Diabetes

Summary: sp2086 is a novel inhibitor of dipeptide base peptidase 4, allows an insulin-independent approach to improve type 2 diabetes hyperglycemia. in this single-dose and multiple-dose study the investigators evaluated the safety, tolerability and pk/pd profiles of sp2086 in type 2 diabetes patients .


Eligibility criteria:
inclusion criteria: * the patient has a definitive diagnosis of type 2 diabetes. * bmi(a measure of a person's weight in relation to height)is between 19 and 30 kg/m2,and the weight is equal or greater than 50kg. * never use the antidiabetic or only use one type oral antidiabetic(except the insulin secretagogues agent). * the patient never use insulin in 3 months of screening. * be willing to accept physical contraception. * sign the informed consents voluntarily and ensure to completed the study. exclusion criteria: * the value of fasting blood-glucose(fbg)\>13.9mmol/l,or hba1c\>10.0%; * known allergy to sp2086 or any of the excipients of the formulation of sp2086; * type 1 diabetes,or gestational diabetes,or other type diabetes; * ever occured acute complications of diabetes such as diabetic ketoacidosis,high permeability syndrome or lactic acidosis. * ever occured the severe hypoglycemia. * history of chronic complication of diabetes(kidney disease,or retinopathy,neuropathy,or lower limb vascular lesion). * the value of serum creatinine over the upper limit of normal range. * ever occured myocardial infarction,acute coronary syndrome, transient ischemic attack. * qtc interval\>450ms(male) or \>470ms(female) or have the history of cardiac insufficiency which the nyha(new york heart association) class over i degree. * have the history of hypertension,and not well control:sbp(systolic blood pressure)\>140 mmhg or dbp(diastolic blood pressure)\>90 mmhg. * have the history of cancer. * the value of alt and/or ast was greater two times of upper limit of normal range,or the stb over the 1.5 times of upper limit of normal range. * the b hepatitis surface antigen or hepatitis c antibody or syphilis antibody or hiv antibody was positive. * had participated three or more clinical trial in one year or had participated one time clinical medicine in one month of screening. * have the history of blood donation in 3 months of screening or received the blood transfusion in 1 months of screening. * have the history of tobacco,alcohol or drug abuse. * history of or current clinically significant medical illness as determined by the investigator.
inhalation chamber management in pediatrics: efficacy of an educational intervention in patients diagnosed with bronchospasm and their family caregivers.

Conditions: Bronchospasm

Summary: several studies show that unnecessary and frequent visits to the emergency department for bronchospasm care are associated with inadequate management of inhalers and poor education on the approach to respiratory distress. main objective: to determine the degree of frequentation to the pediatric emergency department for bronchospasm at 1, 3 and 6 months after the educational intervention. design: randomized controlled clinical trial with two groups: experimental will receive the educational intervention, along with usual care, and control will receive usual care. subjects: pediatric patients (2-15 years) diagnosed with bronchospasm; in home treatment with inhalation chambers; and their parents. emergency department recruitment. follow-up at home


Eligibility criteria:
inclusion criteria: * patients between 2-15 years of age attending the pediatric emergency department of the hospital universitario puerta de hierro majadahonda (huphm) with a mild, moderate or severe bronchospasm crisis and who have used the inhalation chambers on at least one occasion; with autonomy in the use of the inhalation chambers at home exclusion criteria: * not understanding spanish
evening primrose oil efficacy in second trimester abortion

Conditions: Missed Abortion

Summary: efficacy of evening primrose oil in shortening the duration of induction in 2nd trimesteric missed abortion


Eligibility criteria:
inclusion criteria: * primiparous women exclusion criteria: * previous uterine incision( cs, myomectomy,) * contraindications to medical or surgical uterine evacuations (eg, hemodynamically unstable, coagulopathy) * evidence of intra-uterine infection * rupture of fetal membranes. * intrauterine device in place. * allergy to prostaglandins or epo
vascular fundus changes in patients with high probability of chronic cerebrospinal venous insufficiency (ccsvi)

Conditions: Ehlers-Danlos Syndrome; Multiple Sclerosis

Summary: the investigators propose that evidence of chronic cerebrospinal venous insufficiency (ccsvi) may be evident in the vasculature of the fundus. the investigators will be examining fundi of multiple sclerosis patients and ehlers-danlos patients to see if evidence of ccsvi can be found in these patients having high risk for ccsvi. the investigators will read the fundus photos, compared to age-matched normals in a "blind" fashion.

chronic cerebrospinal venous insufficiency (ccsvi) has been proposed as the cause of numerous neurodegenerative diseases of the brain. ccsvi is the result of poor drainage of blood (and cerebral spinal fluid to some degree) from weakened or stenosed veins usually located in the cervical area (most notably the internal jugular veins). although current focus and treatment of ccsvi is on multiple sclerosis, ccsvi has also been implicated as a potential cause of alzheimer's disease and parkinson's disease. additionally, patients with ehlers-danlos syndrome (eds) -- a disorder of connective tissue -- are more prone to developing multiple sclerosis than the general population. many eds patients are known to have weakened and abnormal blood vessels and 40 - 70% of eds patients develop autonomic dysfunction in addition to numerous other symptoms found in patients with ccsvi. in the small subset of eds and multiple sclerosis patients seen at total eye care, the investigators have noticed a vascular irregularity (using the optomap® and examining the results under high magnification) which offers credence to the theory of ccsvi. such objective data has been elusive, excepting for fmri, ultrasound (to a limited degree) and venous angioplasty results. current treatment of ccsvi involves the ballooning and sometimes stenting, of abnormally stenosed veins. the treatment of ccsvi offers hope to many patients suffering from multiple sclerosis. although ccsvi research is in its infancy, many doctors believe that ccsvi is a significant portion of the solution to patients with neurodegenerative diseases of the brain. because ccsvi is a vascular disorder, the investigators hypothesize that the investigators are able to screen candidates for ccsvi via the optomap®.

Eligibility criteria:
inclusion criteria: * age matched normals * patients with diagnosed or suspected ehlers-danlos syndrome and/or diagnosed or suspected multiple sclerosis ("cis") exclusion criteria: * diabetics and patients unable to sit in position for testing are excluded

Keywords: multiple sclerosis ehlers danlos syndrome ccsvi chronic cerebrospinal venous insufficiency fundus retina
an investigational study of esk-001 in participants with normal liver function and participants with mild, moderate, and severe liver damage

Conditions: Hepatic Impairment

Summary: this a phase 1, open label, single dose, parallel cohort study to determine the pharmacokinetics (pk) of study drug (esk-001) in healthy volunteer participants, and participants with mild, moderate, and severe hepatic impairment.

this clinical trial information was submitted voluntarily under the applicable law and, therefore, certain submission deadlines may not apply. (that is, clinical trial information for this applicable clinical trial was submitted under section 402(j)(4)(a) of the public health service act and 42 cfr 11.60 and is not subject to the deadlines established by sections 402(j)(2) and (3) of the public health service act or 42 cfr 11.24 and 11.44.)

Eligibility criteria:
key inclusion criteria for all participants: * body mass index between 18.0 and 40.0 kg/m2 key inclusion criteria for participants with hepatic impairment: * diagnosis of chronic (\> 6 months), stable hepatic impairment with no clinically significant changes within 30 days prior to dosing, as determined by medical history key exclusion criteria for all participants: * uncontrolled treated/untreated hypertension (systolic blood pressure ≥ 160 mmhg and/or diastolic blood pressure ≥ 105 mmhg), or uncontrolled treated/untreated hypotension (systolic blood pressure \ 100 bpm. measurements may be repeated once in order to determine eligibility key exclusion criteria for healthy volunteer: * significant history or clinical manifestation of any metabolic, allergic, dermatological, hepatic, renal, hematological, pulmonary, cardiovascular, gastrointestinal, neurological, respiratory, endocrine, or psychiatric disorder, as determined by the investigator or designee. * positive hepatitis panel and/or positive human immunodeficiency virus test. key exclusion criteria for participants with hepatic impairment: * history of any uncontrolled or unstable renal, hematological, gastrointestinal, neurological, endocrine, or psychiatric disorder, as determined by the investigator or designee, within 6 months prior to screening. * history or current diagnosis of uncontrolled or significant cardiac disease indicative of a significant risk of safety for participation in the study. * liver function tests outside the appropriate reference ranges that are not consistent with hepatic dysfunction, as determined by the investigator or designee. * qtcf \> 480 ms for males or \> 490 ms for females at screening or check-in, as confirmed from the mean of the original value and 2 repeats.
effects of preoperative dexamethasone study on qol after vaginal reconstructive surgery for pop

Conditions: Pelvic Organ Prolapse; PONV

Summary: the investigators hypothesize that preoperative administration of 8 mg iv dexamethasone will benefit patients' perceived quality of recovery after surgery.

this is a randomized controlled trial involving single administration of 8 mg dexamethasone per iv preoperatively among women undergoing vaginal reconstructive surgery for pelvic organ prolapse.

Eligibility criteria:
inclusion criteria: * women aged 18-81 years old who are scheduled to undergo a major vaginal reconstructive surgery, including hysterectomy with or without hysterectomy exclusion criteria: * daily use of steroids or antiemetic agents such as zofran, reglan, compazine and phenargan within one month of surgery * regional anesthesia for surgical procedure * chronic pain requiring opioid treatment daily * history of allergy to the study medication * severe renal and liver disease * pregnancy * non english speaking * psychiatric disorder that will preclude completion of questionnaires * minor surgery that does not involve overnight admission * surgery that does not involve hysterectomy or vaginal intraperitoneal apical suspension * hypersensitivity reaction to steroids * evidence of systemic fungal infection * evidence of any systemic infection * uncontrolled diabetes

Keywords: pelvic organ prolapse surgery dexamethasone postoperative nausea and vomiting peroperative administration